Understanding the health effects of caregiving stress: New directions in molecular aging

Lisa M Christian; Stephanie J Wilson; Annelise A Madison; Ruchika S Prakash; Christin E Burd; Ashley E Rosko; Janice K Kiecolt-Glaser

doi:10.1016/j.arr.2023.102096

Understanding the health effects of caregiving stress: New directions in molecular aging

Ageing Res Rev. 2023 Dec:92:102096. doi: 10.1016/j.arr.2023.102096. Epub 2023 Oct 28.

Authors

Lisa M Christian¹, Stephanie J Wilson², Annelise A Madison³, Ruchika S Prakash⁴, Christin E Burd⁵, Ashley E Rosko⁶, Janice K Kiecolt-Glaser⁷

Affiliations

¹ Department of Psychiatry & Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, USA; The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA. Electronic address: Lisa.Christian@osumc.edu.
² Department of Psychology, Southern Methodist University, University Park, TX, USA.
³ The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA; Department of Psychology, The Ohio State University, Columbus, OH, USA.
⁴ Department of Psychology, The Ohio State University, Columbus, OH, USA; Center for Cognitive and Behavioral Brain Imaging, Ohio State University, Columbus, OH, USA.
⁵ Departments of Molecular Genetics, Cancer Biology and Genetics, The Ohio State University, Columbus, OH, USA.
⁶ Division of Hematology, The Ohio State University, Columbus, OH, USA.
⁷ Department of Psychiatry & Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, USA; The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA.

PMID: 37898293
PMCID: PMC10824392 (available on 2024-12-01)
DOI: 10.1016/j.arr.2023.102096

Abstract

Dementia caregiving has been linked to multiple health risks, including infectious illness, depression, anxiety, immune dysregulation, weakened vaccine responses, slow wound healing, hypertension, cardiovascular disease, metabolic syndrome, diabetes, frailty, cognitive decline, and reduced structural and functional integrity of the brain. The sustained overproduction of proinflammatory cytokines is a key pathway behind many of these risks. However, contrasting findings suggest that some forms of caregiving may have beneficial effects, such as maintaining caregivers' health and providing a sense of meaning and purpose which, in turn, may contribute to lower rates of functional decline and mortality. The current review synthesizes these disparate literatures, identifies methodological sources of discrepancy, and integrates caregiver research with work on aging biomarkers to propose a research agenda that traces the mechanistic pathways of caregivers' health trajectories with a focus on the unique stressors facing spousal caregivers as compared to other informal caregivers. Combined with a focus on psychosocial moderators and mechanisms, studies using state-of-the-art molecular aging biomarkers such as telomere length, p16^INK4a, and epigenetic age could help to reconcile mixed literature on caregiving's sequelae by determining whether and under what conditions caregiving-related experiences contribute to faster aging, in part through inflammatory biology. The biomarkers predict morbidity and mortality, and each contributes non-redundant information about age-related molecular changes -together painting a more complete picture of biological aging. Indeed, assessing changes in these biopsychosocial mechanisms over time would help to clarify the dynamic relationships between caregiving experiences, psychological states, immune function, and aging.

Keywords: Anxiety; Caregiving; Cognitive decline; Dementia; Depression; Inflammation; Molecular aging; Social support; Stress.

Publication types

Review

MeSH terms

Aging*
Biomarkers
Caregiver Burden*
Caregivers / psychology
Humans
Stress, Psychological

Substances

Biomarkers

Abstract

Publication types

MeSH terms

Substances

Grants and funding